ABOUT TRADITIONAL CHINESE MEDICINE What is Traditional Chinese Medicine? Traditional Chinese Medicine was originated in ancient China and has a history of over two thousand years. Influenced by ancient Chinese philosophy, culture, and science and technology, Chinese medicine uses the theory of Yin and Yang and the theory of Wu Xing to explain the mechanism of balancing the function of the body. Theory of Yin and Yang While the direct meanings of yin and yang in Chinese are positive and brightness versus negative and darkness, Chinese philosophy uses yin and yang to represent a wider range of opposite forces that are complementary and contradictory that cannot exist without each other. Together, the yin and yang make up the life energy, called “Qi”. Qi is a type of energy that flows through the body through invisible sets of pathways called meridians. The theory of Yin and Yang is fundamental to Theory of Wu Xing the practice of TCM, where the most basic The theory of Wu Xing, the five elements (wood, fire, level of TCM treatment is to seek the balance earth, metal and water) interprets the relationship and of yin and yang in each person. the constant movements and cycles between the physiology and pathology of the human body and the Theory of Zang Fu natural environment. The chart below outlines how the There are two types of internal organs: the natural changes within the body and the environment zang (yin) organs, and fu (yang) organs. Zang affect your health. organs include: the liver, heart, spleen, lung, and kidney. Fu organs include: the gallbladder, small intestine, stomach, large Wood Fire Earth Metal Water intestine and bladder. Late Season Spring Summer Summer Autumn Winter Linked to the theory of Wu Xing: the theory of Zang Fu explains the physiological function, Zang/Yin pathological changes, and the mutual Organs Liver Heart Spleen Lung Kidney relationships of each organ (refer to chart Fu/Yang Gall- Small Large under Theory of Wu Xing). Each organ has Organs bladder Intestine Stomach Intestine Bladder their own characteristics and functions; zang organs mainly store the vital substances (qi, Direction East South Middle West North blood and body fluids), while the fu organs perform the functions of receiving and Taste Sour Bitter Sweet Pungent Salty digesting food, and transmitting and excreting waste. Tissue Tendons Vessels Muscles Skin/Hair Bones

Linked to the theory of Yin and Yang: if there Blue / is an imbalance between the zang-fu organ Colour Green Red Yellow White Black system, signs and symptoms that correspond Sense with the zang or fu system will be affected. Organ Eye Tongue Mouth Nose Ear

1 Who can practice traditional Chinese medicine and acupuncture in Ontario? Only registered members of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario are allowed to: • use the protected title(s) of “Traditional Chinese Medicine Practitioner” and/or “Acupuncturist”, and the designation(s) of “R. TCMP” and/or “R. Ac”; • perform the following authorized controlled acts: 1. Perform a procedure on tissue below the dermis and below the surface of a mucous membrane for the purpose of performing acupuncture. 2. Communicate a TCM diagnosis identifying a body system disorder as the cause of a person’s symptoms using TCM techniques.

What to expect at a typical TCM visit When visiting a TCM practitioner and/or 3. Assessment acupuncturist, patients should expect the Listening and Smelling: The TCM practitioner will following procedures: after the patient gives listen to the sound of the patients breathing, voice, consent to treatment, the practitioner will and the quality of cough. The practitioner will also gather information of the patient's medical observe any breath odour. history, perform assessments and provide a diagnosis and treatment plan. Touching: The TCM practitioner will perform a palpation of the body to discover body temperature, 1. Consent Form body moisture, pain, and strategic acupuncture points. Practitioners are required by law to explain the proposed treatments to their patients and to Tongue Diagnosis: The TCM practitioner will make receive their patients’ informed consent for the observations of the patient’s tongue, by examining the proposed treatment. A patient has the right to colour, coating, and shape. The practitioner will also receive sufficient information in order to make observe the patient’s face, eyes, etc. an informed decision on whether to accept treatment. Practitioners must ensure that their Pulse Diagnosis: The TCM practitioner will take the patients know, understand and consent to their patients pulse. This is an important aspect of the TCM assessments or treatments before any practitioners in diagnosing illness, and in some cases, treatments begin. can indicate a problem or weakness before symptoms occur. Each wrist has three positions along the radial Consent must be informed by means of a artery that represent each organ of the body. There meaningful dialogue between the practitioner are 28 different pulse characteristics pertaining to and the patient. Consent may be obtained in position, depth, rate, width, strength, quality, and writing or verbally, or it may be implied. rhythm. However, the College strongly recommends written consent in the form of a signed and 4. Diagnosis and Treatment Plan documented Consent to Treatment form. Based on the patient’s medical health history and assessment, the TCM practitioner will provide a TCM 2. Information Seeking diagnosis on the imbalance in the body using the The TCM practitioner will gather information theories of yin and yang and the five elements. about the patient’s medical health history and family health history. In addition, the A detailed explanation of the diagnosis will be practitioner will record any medications explained to the patient on how to remove what is currently taking, and any current symptoms by excessive and/or replenish what is deficient from the inquiring about the patient’s energy levels, body. The TCM practitioner may use a combination of sleep patterns, appetite, thirst, sweating, chills herbal medicine and treatment modalities, such as or fever, and any complaints of body pains, acupuncture, moxibustion, cupping, gua sha, and tui bowel habits, urine and menstruation. na, as part of the treatment plan.

CTCMPAO - About Traditional Chinese Medicine 2 What type of treatments do Traditional Chinese Medicine Practitioners perform?

Traditional Chinese Medicine Practitioners use a number of treatment options based on the patient diagnosis. This may include a combination of herbal medicine and treatment modalities, such as acupuncture, moxibustion, cupping, gua sha, and tui na.

Acupuncture Moxibustion Acupuncture is the insertion of thin, metal needles to Moxibustion is a form of heat therapy in which stimulate specific points of the body that reach mugwort (a commonly used herb) is burned on meridians. These stimulation points are called (direct moxibustion) or near the skin (indirect acupuncture points or acupoints. Traditional Chinese moxibustion). The purpose of moxibustion is to medicine holds that there are 365 commonly used heat acupuncture points in order to stimulate acupuncture points on 20 meridians on the human the flow of qi and strengthen the blood. body. Typically, it takes 15 to 30 minutes of There are two types of direct moxibustion: manipulating the needles in these acupuncture points scarring and non-scarring. In the procedure of and 30 to 60 minutes of retaining the needles. By scarring moxibustion, the moxa is placed on an doing so, it regulates the flow of qi throughout the acupuncture point, burned and remains on the body and restore health to the mind and body, thus skin until it burns out completely. In the balancing the yin and yang. The insertions of needles procedure of non-scarring moxibustion, the are manipulated either by the hand or by electrical moxa is placed on an acupuncture point, stimulation, called electroacupuncture. burned, but extinguished or removed before it Is it safe? Does it hurt? burns the skin. Needles inserted during an acupuncture treatment There are several forms of indirect moxibustion. should be painless. Every patient experience is One method is to light one end of a moxa stick different; patients may experience bruising, and hold it close to the acupuncture point for a bleeding, needle site pain and sensation, or needle few minutes until the area turns red. Another fainting. However, these symptoms may be method uses both acupuncture needles and expected (minimal bleeding) and desired (tingle, moxa. A needle is inserted into an acupuncture tight sensation - "de qi response"). Patients should point and retained. The tip of the needle is then inform the practitioner if any discomfort arises. wrapped in moxa and burned, generating heat Is dry needling the same as TCM acupuncture? to the acupuncture point and its surrounding Dry needling is a technique used by Western area. The moxa is then extinguished and the practitioners such as physiotherapists, needle is removed. chiropractors, and occupational therapists etc. Is it safe? Does it hurt? based on strictly body anatomy in opposed to TCM The risks of heat therapy include burns, blisters, principals. Thin metal needles are inserted in scarring and allergies. It is important for specific muscle trigger points to release tension and practitioners to be aware of the patients’ pain. Dry needling does not apply any TCM tolerance to heat. In the case of direct principals nor diagnosis. Hence, dry needling moxibustion, patients should experience a practitioners are not necessarily receiving the same pleasant heating sensation deep into the skin. level of training as set out by the standards of our However, if the patient experiences strong pain, College. In other words, those who practise dry blistering and scarring, it may indicate that the needling might not meet the requirements to use the moxa is left in place for too long. Therefore, title of "Registered Acupuncturist" or "Registered indirect moxibustion is growing in popularity Traditional Chinese Medicine Practitioner" in the because there is a much lower risk of pain or province of Ontario. burning.

CTCMPAO - About Traditional Chinese Medicine 3 Chinese Herbal Medicine Cupping Chinese herbal medicine is primarily plant based Cupping is a form of therapy that involves the (using leaves, roots, stems, flowers and seeds), but suction of the skin and the surface muscle some minerals and animal products are also used. layer to stretch and be drawn into a cup. These herbs are classified by its energy Cupping is used to encourage the blood flow characteristics and taste property, where a of the body and treat conditions such as acute combination of different herbs is used to balance the or chronic pains, respiratory problems and yin and yang energy patterns of the body. These musculoskeletal problems. formulas are packaged as powders, pastes, lotions or There are two methods of cupping: dry and wet. tablets, depending on the herb prescribed and its Each method includes different types of cupping. intended use. The two most common types of dry cupping Gua sha are fire cupping and suction cupping. In the Gua sha is a technique in which a smooth-edged tool, procedure of fire cupping, the inside of a glass such as Chinese soup spoon or pieces of honed jade, cup is heated with fire, then placed onto the is pressed and stroked on a lubricated area of the skin. As the air inside the cup cools, a vacuum body until a mark appears. Press-stroking is to be is created causing the skin and muscle layer performed sequentially - line by line and in one to rise and redden into the cup. In the direction - until the entire area is completed. procedure of suction cupping, a plastic or Is it safe? Does it hurt? silicone cup, with valves at the top that attach When done correctly, Gua Sha should not be painful. to hand pumps, are placed on the skin then The mark is a result of bruising and broken capillary pumped to create suction by removing the air. blood vessels (sha). Raising sha removes abnormal qi The cups in both methods are to be left on the and blood stagnation, and reduces inflammation; patient’s skin for 2 to 10 minutes. therefore, it provides immune protection, and In the procedure of wet cupping, the skin is improves the circulation of the body. According to punctured by sterile needles before either the Western medicine, it functions on: the nervous system fire cups or suction cups are placed on the to enhance human defense mechanism, and the skin. This technique draws out the blood, thus circulative system which speeds up the circulation of removing harmful substances and toxins from blood and lymph to enhance metabolism. the body. The cups are to be left on the Tuina patient’s skin for 2 to 10 minutes. Tui Na is a type of therapy based on TCM theories of Is it safe? Does it hurt? Zang-Fu organs and meridians, but it also combines After the cups are removed from the session, the anatomy and pathological diagnosis from Western temporary red marks might show on the medicine. Like acupuncture, tui na involves the patient’s skin. These marks might remain on stimulation of specific points of the body that reach the skin for up to 10 days. These marks are a meridians. The main difference is that acupuncture result of bruising and minor bleeding from uses needling techniques, whereas tui na uses broken capillary blood vessels. Chinese massage and manipulation techniques. Some common techniques include: gliding, kneading, As with any heat therapy, there may be a rolling, pressing, pulling, chopping, and vibrating. chance of burning and scarring. Further, wet cupping carries a risk of exposure to and Each session lasts between 30 to 60 minutes, transfer of infections and bloodborne diseases, depending on the patient’s necessity. Tui na helps if needles are not properly sanitized. promote the blood circulation of the body, and enhances the qi blood supply. Tui na is used to treat a variety of pain, musculoskeletal syndromes, and digestive, respiratory and reproductive system disorders. Some common contraindications include: skin infection or epidemic disease.

CTCMPAO - About Traditional Chinese Medicine 4